Transforming Nursing

With national health care reform and the services of health care professionals already in greater demand than ever before, the field of nursing is witnessing a transformation. In the years to come, nurses will likely be taking on more extensive training and increased responsibilities in terms of patient care.

Among the first group of graduates from the Doctor of Nursing Practice Program are from left, Millicent Malcolm ’99 MS, ’10 DNP, Victoria Odesina ’09 DNP and Karen Myrick ’89 (NUR), ’99 MS, ’10 DNP. Photo by Lanny Nagler

The American Association of Colleges of Nursing recently proposed replacing existing master’s degree programs in nursing with doctorate programs as a requirement for entry into advanced practice nursing by 2015. In October, the Institute of Medicine issued a report advising that nurses’ responsibilities and education should change significantly to meet the increasing demand for patient care. Such recommendations anticipate that doctorate-level programs would offer nurses the more advanced level of education they need to provide care to patients as part of a comprehensive health care team.

Anticipating the changing role of nurses and recognizing the need for new educational models in training nurses, two years ago the UConn School of Nursing launched its Doctor of Nursing Practice (DNP) degree program, the first in Connecticut and one of a handful in New England. The School of Nursing’s master’s program will become part of the requirements for obtaining a Doctor of Nursing Practice degree.

Unlike traditional doctoral programs that center on academics and research, the UConn DNP focuses on developing clinical scholars. Its goal is to empower nurse practitioners, clinical specialists, midwives, anesthetists, and administrators with the latest scientific research and training, so they can address issues and improve patient outcomes as they practice in hospitals, nursing homes, schools, and clinics.

“We need better educated clinical practice leaders who live in the clinical practice setting, who have higher levels of education, and who can lead some of these initiatives that we desperately need in the U.S. health care system,” says Sandra Bellini, coordinator of UConn’s DNP program and a national leader in DNP education.

Addressing Real-World Challenges

The goal of the program is to empower nurse practitioners, clinical specialists, midwives, anesthetists, and administrators with the latest scientific research and training, so they can improve patient outcomes.

While many DNP programs are treated as advanced professional certifications, UConn developed its program after its more traditional doctoral program, which requires a dissertation. Regina Cusson, associate dean for academic affairs and advanced practice in the School of Nursing, says the dissertation requirement maintains the high standards the school expects from its students, calling on them to address a real-world nursing problem and propose ways to improve care.

She says the DNP fills an important gap in nursing practice.

“To me, what’s been missing in nursing is that you have academics teaching and some practicing, but it’s very difficult to do both in a full-time way,” says Cusson. “Because they’re in the clinical practice setting, clinicians know what’s important and what needs to be changed. Educating them about how to answer those questions and bring about change, helping them to become change agents and leaders, to me that’s what’s exciting about this.”

Participants in the DNP program conduct their clinical dissertation studies at academic centers throughout New England, including the University of Connecticut Health Center in Farmington.

“We are very proud to have had three of our nurse practitioners at the Health Center as part of the first class to complete the DNP Program,” says Ellen Leone, the Health Center’s associate vice president of operations and director of nursing.

“To me, their drive to pursue this degree speaks volumes about the caliber of nurse leaders that they are.”

Next Generation of Nurses

Victoria Odesina ’09 DNP typifies the kind of experienced and committed nurses who enroll in the program. An advanced practice registered nurse (APRN) with 30 years’ nursing experience, she spends most of her time managing the HIV/AIDS medication adherence program at the UConn Health Center. “I chose to enter UConn’s DNP program because the curriculum met my goal of building a professional legacy to improve patient lives,” Odesina says, noting that her decision to obtain a terminal degree in nursing was as much personal as professional. Two of her three children have sickle cell disease, a blood disorder that can cause painful blockages of the blood vessels and organ damage.

The Doctor of Nursing Practice degree focuses on developing clinical scholars who can become change agents and leaders.

As part of her clinical dissertation, Odesina developed new protocols for sickle cell pain management in hospital emergency departments to reduce the time from when sickle cell patients arrive in crisis to when they receive their first medication to ease their pain. Using the latest evidence-based research, she reduced delays in administering medication by nearly half.

Like Odesina, Millicent Malcolm ’99 MS, ’10 DNP has an innate desire to try to improve existing health care. Working with the elderly for 30 years, Malcolm has seen older patients get lost in today’s health care system. She has developed a popular house call program and sees many patients who are too frail or sick to come to her office.

“Often, elderly patients are just considered old adults. In fact, normal aging, multiple medical problems, and multiple prescriptions and over-the-counter medications result in elderly patients needing the eyes of a geriatric specialist to understand the complexities of their medical, functional, psychological, and spiritual condition,” says Malcolm, another of UConn’s first DNP graduates, who also teaches in the School of Nursing. “I feel there is a lack of knowledge on caring for the elderly, and wanted to be involved in imparting important geriatric care principles to future nurses.”

For Karen Myrick ’89 (NUR), ’99 MS, ’10 DNP, obtaining a DNP degree capped a long-term commitment to UConn’s nursing program. She is a “triple Husky,” with bachelor’s, master’s, and doctoral degrees, who teaches in the doctoral program and works as a nurse practitioner treating young athletes at Elite Sports Medicine in Farmington, a division of the Connecticut Children’s Medical Center.

“I knew that in my role as a nurse practitioner, I wanted the skills to advance the profession and serve as a leader in promoting the use of evidence-based information within my own practice,” says Myrick, the president of her graduating class, who helped form the UConn Student Nurses’ Association.

Myrick says she and other nurses are poised to bridge the existing gap between available health care coverage and accessible care. Bellini agrees.

“If you want to improve patient outcomes on a broad level, you need people at the DNP level to bring about that kind of change,” Bellini says. “The sustainability of improvement projects can really be problematic if you don’t have people who live there day in and day out. That’s really what this is all about – driving toward improvement and sustaining those improvements.”

This article was published in the Spring 2011 edition of UCONN Magazine.